Hospital Fair Price

Hospital Fair Price Initiative

Background

Across the country, employers are reporting the largest increase in health care costs in a decade – between 5 to 9 percent- according to leading health care brokerages. There are clear failures in the hospital market – negotiated prices well above the amount necessary for hospitals to break even and no correlation between the price of hospital care and the quality of care provided. In fact, prices far exceed what Medicare pays, with some hospitals charging as much as 3 to 5 times the Medicare rates for the same services with prices vary wildly for the same service even within the same city. This is driving employers and employer coalitions across the country to demand fair hospital prices – this is especially important in their role as plan sponsors and fiduciary.

MBGH is one of 15 National Alliance of Healthcare Purchasing Coalitions who are participating in the Hospital Fair Price Initiative. The campaign, which takes place in 2023-24, will educate and work with employers on price transparency issues in Illinois using the leading data analytics sources below. MBGH, employer members and leading experts will also engage with state policymakers and health care stakeholders using a results-oriented policy agenda with the initiative will include comprehensive employer communications.

Business Case for Employers

  • Americans pay more for inpatient and outpatient hospital care than anyone else in the world
  • Hospital prices are the leading driver of high and rising health care costs in the US with employers providing coverage for >180 million people
  • Hospitals and health system consolidation has dramatically raised prices
  • Market is dominated by large hospital monopolies that engage in anticompetitive behavior
  • We can’t rely on health systems and health plans to course correct; the era of cost-shifting has run its course

There is a need for accountability by hospitals and health systems now. Employers must engage with hospital systems and health plans to work toward better prices. Employers and employer coalitions must calling on policymakers to enact changes that give employers the tools they need.

Employer Resources

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